the night of ingestion.

INGESTION PART ONE


Sweet kind 85 year old man walks in cute as can be. When asked to state his complaint he
says he thinks he swallowed his dentures. He said he went to bed and when he woke up his
teeth were missing and his throat was sore. After the initial shock of hearing the story
i sent him to xray to see if we can see his teeth. I'm thinking to myself " how the hell?"
but nonetheless, he went to xray. As we waited for the xray results we chatted. This man was so cute. He was kind and had a gentle demeanor. I asked him what medications he takes at home and he pulled out a crumpled old piece of paper from 1952. He broke my heart,so i took his list and went over to the computer and typed it up for him and cut it to wallet size.He was SO appreciative, it made my night. So....we wait for
the xray results and much to my surprise (sarcasm)...there were no dentures in his throat,
abdomen or intestines. All clear! I told him they were not in his body and you know what he said?

"I had a feeling I hadn't swallowed them, I think i know what happened to them."
"What do you think?" I asked.

"Well,my wife died 4 years ago and she was always playing pranks on me so I figure she probably stole them in the middle of the night and is laughing at me from up in heaven".
I died. I literally felt my heart open up and swallow this lovely man.
I told him I agreed and thought that this was her best prank yet. He winked at me ;)


INGESTION #2


to hate yourself so much that you'd swallow a handful of razor blades

i can't imagine.

to be screaming in pain at something you inflicted upon yourself.

That is a kind of hatred i can't wrap my mind around.

The ct scan literally showed 5 razor blades at various stages of digestion
just destroying her insides. The screams coming from the room resonated all night long and
we, here in the ER, are left to contemplate our own self confidence, self assurance and sense
of value. I know now, after seeing and hearing this patient, that I love and value myself and
that nothing would make me inflict that kind of harm on my body. Our bodies are so sacred. Why
must people torture and neglect them. Whether it be drugs or razor blades....there is no difference.
One day their bodies will shut down, and in those final moments, I know for a fact that they will
wish they had another chance to make the right decision. I know that because I see them here night
after night, dying right infront of me. They look at you with those wide eyes and your heart aches. You know they did it to themselves,but that doesn't change the outcome. Death is inevitable.

Life lesson of the night: love yourself enough to take care of your body, mind and spirit.
AND....always hide your dentures when you take them out, or the tooth fairy might just grab em ;)

"my ass fell out of my ass"

Emma....you have a new patient.....she's in the room waiting for you....

What is her stated complaint?

She says her ass fell out of her ass.

I'm not following you?

Her ass literally fell out of her ass.

Hi there...my name is Emma and i'm going to be your nurse here in the ER. What exactly happened?

I had a baby 2 days ago. I didn't use any medicine, no epidural, nothing. I pushed really hard everything was okay until tonight. I was laying in bed and i felt my ass fall out. It hurts so bad. Its on the outside of my body. I can't move, can't poop. My husband said my butt fell out.



this is what i see:

I call the doc in and we ask the woman to roll over so we can figure out what exactly she is talking about. She rolls over and .....................

brace yourself.........

seriously.......................


............................





........................................you're sure you wanna see this?

no her ass did not fall out of her ass. She has hemmorhoids. Really really large ones that were internal and were pushed out by childbirth.

hemorrhoidsplural of hem·or·rhoid

Noun:

A swollen vein or group of veins in the region of the anus They can be internal and external and can either go away with some cream or can be cut off. Usually a small incision is made and they disappear. NOT in this case! We had to call in a surgeon and prep her for surgery. Poor thing. She was so stressed about the next time she has to poop. I can't even imagine how much that is gonna hurt. Ouchhhhhhhhhhhhhhhhhhhhhhhhhhh. LIFE LESSSON: think twice about having kids ;) or at least have a c section lol.

MY SHIFT ...start to finish....

I love my job. I am feeling more and more comfortable with my day to day (or night to night ) responsibilities and definately don't feel overwhelmed anymore. Everyday there are at least ten new things i learn but I feel like the knowledge is stacking up in my brain and becoming easier to absorb.

For my friends and family that ask what my usual routine is:

6:45 pm arrive at the hospital and put my stuff away in my locker in the breakroom.

6:55 pm meet with the other nurses and paramedics to discuss our nights events. Things to look out for, new procedures etc. Listen the the charge nurses' pep talk!

7:00 head out to the ER floor to find out what area i'm working in that night and who I need to get report from.There are a few different areas I could be in. AREA 1 and AREA 2 are adult rooms and usually the most critical patients go there (including all the codes and trauma). FAST TRACK is where the quick in and out patients go and anyone who is pregnant and having vaginal bleeding(This area does a lot of pelvic exams and obgyn type stuff). PEDS means you are in the pediatric ER and you share the patient load with the other PEDS nurse. You don't really have  patients to yourself, you both just trade off and help each other out. I PRAY EVERY NIGHT TO BE ON THE ADULT SIDE. I am trained in both adult and pediatric emergency medicine but I can't seem to get used to needles and IV's in little screaming sick babies. And if they aren't getting needles they are just sneezing or barfing on you. I hate it. The parents are crazed, the kids are miserable and I can't find a damn vein to save my life. I was told i'm good with the kids but i definately think they are talking about when they are about 10 years and up. I love the teens, I  relate well with them...but the lil ones...no maaaaam.

7:05 I find my area and find the day nurse that's in it. I walk with her from room to room and find out who's in the room, how long they've been there, what their diagnosis is, what was done and what still needs to be done. In a perfect world...the documentation is complete, the labs and blood are drawn and sent and the patient has been medicated. It's awful to arrive at work and have to catch up on someone elses slow pace. Plus, you don't even know these patients, their story, their pain. I introduce myself while double checking that all the rooms are stocked with suction (in case of a breathing issue) and ambu bags (in case I need to be someone's lungs for them).

7:10 I rock and roll. I know that if i get behind now, i'm screwed for the rest of the night. I say hey to the docs and check the giant board to see what is flashing red that needs to be done STAT. I put on my rollerskates and start hustlin. It's always a good indication of how the night is going to go depending on which doc is on. Some love to order every test in the book which slowsssssssssssss you down a lot, while some just use their knowledge and assessment skills to determine the prognosis. The less labs = the less medicine = early discharge home. The sooner I can fix them and send them home the better.....for everyone involved.

7:15-2:30 am Work Work Work, Patients will come, get treated, sign the paperwork and leave, you will clean the room turn the corner and see another patient coming right towards you...its an endless cycle but as long as you are fast, smart and take things in stride, you won't lose your cool or your mind :)

3:00am EAT LUNCH + red bull

3:30am-7:00 continue with patient care, do some online coursework the hospital delegates we do and usually laugh hysterically. The ER slows down "sometimes" at this time and the nurses, techs and docs have a grand old time pranking each other, telling geeky stories and releasing some of the stress of the night. As i said, it usually slows down, that is not always. Some days its none stop and your feet and legs are throbbing come 7 am but other days you can chill for a bit and actually sit down!

7:05am give report to the day shift, clean all your rooms, finish any documentation you may not have finished and smile a lot cause sleep is coming soon.

7:10 head upstairs to the hospital Medical Surgical/telemetry or ICU Floors to visit any patients I may have admitted to stay over night. The patients are always surprised to see their ER nurse visiting and it makes them feel good to be remembered. I think this is a cool thing. It's exhausting to walk all over the hospital after 12 hours on the clock but wouldn't you want someone to come visit you?

7:20 Drive home fast, pee finally and sleeeeeeeeeeeeep.

That's my 12 hours in the ER. It is a long shift and it doesn't involve a lot of sitting but damn, I am so blessed to be in the field i'm in. Emergency Medicine is fascinating, fast paced and everchanging. I work with people who i not only consider my coworkers but some of my best friends. I will be falling behind and be running (literally) into a room to draw blood only to find my buddy in there doing it for me. Then i'll head next door to give a med and i'll see my friend walking towards me with the meds already ready for me to give. These nurses are amazing and every time one of them helps me, it makes me want to pay it forward. It has created this cycle of incredible teamwork and comraderie. I KNOW it's not like this everywhere. I am truly happy with where I am in my career thus far and I cannot wait to see what the future is going to bring.

Here's to loving where you work........Onward and upward..................